Define Chondrolysis Signs and Symptoms and Hip Treatment

Have you ever suffered from any problem of broken cartilage? Then it might be due to Chondrolysis, as an effect of intra-articular infusion of some anesthetic agents such as bupivacaine, ropivacaine, levobupivacaine, or lidocaine. All these agents being toxic to cartilage results in the breakdown of your cartilage, which occurs with intense pain & discomfort. Wanna know more about this disorder? Okay! Follow us to know about chondrolysis treatment!

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Define Chondrolysis and What Are Its Types?

Define Chondrolysis

Chondrolysis, whose medical term is acute cartilage necrosis, is acute cartilage damage to your body’s femoral head. This complication is mainly linked with SCFE or Slipped Capital Femoral Epiphysis. Also, it’s directly associated with some infections especially septic arthritis & which is a carelessly understood phenomenon.

It was Elmslie who, for the first time (in 1913), described this disease as a drawback or complication of SCFE. In 1930, Waldenstrom defined it as a particular entity that results from avascular necrosis. 

Women get Chondrolysis more than men. Also, most people encounter it in their life’s second decade. African American individuals are more vulnerable to this disease. The signs of Chondrolysis are generally seen or experienced after two to four months from the time of the treatment. 

Nevertheless, in some unique cases, Chondrolysis may exist in the preliminary presentation before treatment. Also, it can happen suddenly before any treatment is done or may be detected at the time of the patient’s 1st presentation of SCFE.

There is the possibility that you may develop Chondrolysis after undergoing any other kind of treatment. Nonetheless, indeed, this condition is particularly linked with your body’s pin joint penetration. And also, the necessity of some other factors (like a slip or an immune reaction) for producing chondrolysis can’t be denied. 

Where Does It Occurs?

Chondrolysis can be of various types depending on the places of your body where it occurs. They are chondrolysis of the hip, chondrolysis of the shoulder & chondrolysis of the knees.

This ailment’s hallmark is the narrowing of your joint space. 

Read more: Erosive Osteoarthritis

Acute Chondrolysis

An acute hip chondrolysis may be defined as a rare condition in which you will feel an insidious onset of pain in your hip & restraint in your movement in alliance with the radiographic indication of your articular cartilage’s progressive loss.

After acute hip chondrolysis, there’s a chance that fibrous ankylosis of your hip joint happens. However, spontaneous partial cartilage recuperation is possible in such cases.  

In the case of children’s chondrolysis of the hip, it’s difficult to point out because of their femoral head’s incomplete ossification.

This disease is highly suggestive in an entirely ossified hip where fifty percent of your joint space is lost compared to those whose contralateral side is unaffected or whose absolute measurement is 3 mm/smaller than that. 

Hip chondrolysis may be an idiopathic chondrolysis or a chondrolysis that is secondary to other pathology of the hip (mainly SCFE or LCP disorder). It’s associated with severe trauma, inflammatory arthritis, Stickler syndrome, prolonged immobilization, septic arthritis & Marfan syndrome.

Though it’s believed that spondyloarthropathy is also associated with hip chondrolysis, there’s yet no confirmation regarding it. This condition is an autonomous subform of juvenile (minor) arthritis for some authors. 

Shoulder Chondrolysis

A devastating condition is an acute shoulder chondrolysis or chondrolysis of your body’s glenohumeral joint. You can expect unexpected pain accompanied by loss of joint mobility for certain weeks/months, typically after you undergo arthroscopic shoulder surgery.

This devastating acute ailment of shoulder chondrolysis is a greatly upsetting diagnosis faced by various shoulder surgeons over the past decade.

The cartilage’s global dissolution ensues both on the patient’s glenoid & his humeral head. Also, it comes with the characteristic outcomes of your body’s joint space narrowing, subchondral cystic changes & Periarticular bone edema without any osteophyte formation. 

Although the chondrolysis of your body’s glenohumeral joint is associated with the usage of radiofrequency-based energy in your shoulder, contrast medium’s intra-articular injection, infusion of postoperative pain pump, low-grade infection, usage of natural & bioabsorbable suture anchors, small case reports or case series have brought about various difficulties in extrapolating significant data concerning the real etiology of this disease.

You can prevent shoulder chondrolysis by avoiding the usage of any pain pump or heat energy while treating any of your shoulder disorders.

Knee Chondrolysis

The knee chondrolysis refers to the damage to the smooth articular cartilage of one’s knee. This smooth knee-based cartilage allows easy & smooth gliding of two joint surfaces within one’s knee.

With the thinning of this cartilage, the joint space gets narrowed. As a result, extreme pressure is put on the joints, causing painful symptoms. And this ultimately results in joint arthritis. 

The knee cartilage gets fragmented in one knee compartment or all three compartments. 

That includes the femur’s both sides, top, bottom, tibia & patella. 

Tibia is the lower leg bone, femur, thigh bone & patella, the kneecap. Your knee cartilage may either get partly worn down or fully towards the bone in each of the (three) areas. 

Before the joint degeneration that results in arthritis, full-thickness chondrolysis occurs typically. It’s not always possible to stop the degenerative process through proper treatment. Everything depends on the main cause of the problem.

But, avoiding pain-pump after any ACL surgery may help to prevent this kind of chondrolysis. This is because the drug inside the pain pump comprises a numbing agent (known as bupivacaine) & this numbing agent is toxic to the cartilage cells (chondrocytes) of our body. 

Chondrolysis Signs And Symptoms

Here are the various signs & symptoms of different types of chondrolysis:

Chondrolysis Signs And Symptoms

Symptoms Of Hip Chondrolysis

If you have Chondrolysis in your hip, you will experience any or all of the following signs & symptoms in your body:

  • Pain & limp resulting from progressive loss of the space of articular cartilage because of a presumed inflammatory process that is undefined
  • Stiffness & continual pain in your groin area
  • Stiffness & continual pain in your upper thigh 
  • Trouble in walking & doing other activities
  • Reduction in your hip’s arc of motion in all planes
  • Extreme painful motion at the time of your hip examination 

Read more: Left shoulder osteoarthritis

Chondrolysis Shoulder Symptoms & Signs:

  • Loss of shoulder mobility 
  • Abnormal stiffness of your shoulder
  • Extreme pain that worsens with the movement or rest of the shoulder
  • Declining range of motion, secondary to your shoulder pain & distress
  • Hastily advancing pain & discomfort in the affected region
  • Your shoulder’s glenohumeral joint area gets narrowed (as identified by Radiography) 
  • Crepitus is where your shoulder elicits a grating sensation (a clicking, popping, or chopping sound/noise) where the friction between the cartilage & bone results in the fracture of your joint bone parts.
  • Marrow edema or swelling (identified by MRI)
  • Loss of (diffused) bipolar articular cartilage (identified by MRI)

Chondrolysis Of Knees Symptoms & Signs:

  • Extreme pain in the knees
  • Hastily advancing pain & discomfort in the affected region
  • Abnormal stiffness in the knees

Chondrolysis Hip Treatment:

In case of chondrolysis of your hip & fibrous ankylosis of your hip joint, spontaneous partial cartilage recuperation can be done. 

Bed rest, salicylates, steroids, traction nonsteroidal anti-inflammatory drugs, & physical therapy are not able to modify the chondrolysis course. 

However, various doctors & nursing homes have reported a success rate after they injected intraarticular cortisone injection in the body of their chondrolysis patients.

According to their statement, operational manipulation, pursued by a strenuous physical therapy program, also assisted the patients in quick recovery. In case of persistence of drastic joint space narrowing & restraint of joint motion, it is good to choose arthrodesis or arthroplasty. 

Treatment Of Shoulder Chondrolysis

Non-surgical Management

Through physical therapy & indoor exercise programs, that improve your range of motion & decrease capsular tightness. Also, these therapies & programs will help reduce the amount of your joint irritation & balance the rotator cuff to resist asymmetrical motion & lower the forces over your glenohumeral joint. 

Surgical Method

With the ineffectiveness of the non-surgical method, the doctor goes for the surgical one. He may choose to do surgeries like total shoulder arthroplasty, prosthetic articular resurfacing & hemiarthroplasty.

For extensive chondral damage or damage to the labrum, biceps, or the rotator cuff, the doctor recommends the debriment procedure. 

Treatment For Chondrolysis Of Knees

As the first line of solution for your knee chondrolysis, the doctor may advise for your conservative care. Other than this, doctors also try steroid injections, activity modification, anti-inflammatory usage & microfracture for treating knee chondrolysis of their patients, whichever works for whom.

They also advise their patients to endure their symptoms as long as they can endure them before opting for a complete knee replacement. 

If any patient’s knee chondrolysis is because of some reason other than pain-pump use, viscosupplementation helps. It’s an injection comprising a slippery fluid & that is injected into the joint of a person.

For bupivacaine-induced chondrolysis, successful treatment options are limited at present. However, research is going on to invent a successful remedy for this problem. 

FAQs–

Q.1. What causes chondrolysis?

Answer: Chondrolysis may happen for various reasons; the most important among them is the usage of thermal capsulorrhaphy after an operation or intra-articular infusion of some anesthetic agents (after the operation), bupivacaine, ropivacaine, levobupivacaine or lidocaine in one’s body. All these agents being toxic to cartilage results in the breakdown of their cartilage, which occurs with intense pain & discomfort.

Q.2. What is chondrolysis of the hip?

Answer: An acute hip chondrolysis may be defined as a rare condition in which you will feel an insidious onset of pain in your hip & restraint in your movement in alliance with the radiographic indication of your articular cartilage’s progressive loss.

After acute hip chondrolysis, there’s a chance that fibrous ankylosis of your hip joint happens. However, spontaneous partial cartilage recuperation is possible in such cases.  

Q.3. How common is chondrolysis?

Answer: Chondrolysis is not a frequent but a rare condition that mostly happens after an operation, mainly if any postoperative pain pump or thermal capsulorrhaphy is used after the operation. 

Q.4. What is chondrolysis of the knee?

Answer: The knee chondrolysis refers to the damage to the smooth articular cartilage of one’s knee. This smooth knee-based cartilage allows easy & smooth gliding of two joint surfaces within one’s knee. With the thinning of this cartilage, the joint space gets narrowed. As a result, extreme pressure is put on the joint, causing painful symptoms. 

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